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The Combined Use of Chemotherapy and Radiotherapy with PD-1 Inhibitor Pembrolizumab in Advanced Cervical Cancer: A Case Report

机译:化疗和放疗与PD-1抑制剂Pembrolizumab晚期宫颈癌的结合使用:案例报告

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摘要

As a result of the limited therapeutic options, advanced cervical cancer is difficult to treat, making the prognosis poor. Therefore, new therapeutic modalities or combinations need to be explored. We herein reported a case of stage IVB cervical cancer which was irresponsive to chemotherapy alone. Based on previous studies and after patient’s consent was obtained, we made a therapeutic plan: chemotherapy (albumin-bound paclitaxel and carboplatin) combined with immunotherapy (PD-1 inhibitor pembrolizumab). After 6 cycles of combined treatment, the patient got almost complete resolution with slight advent event. The treatment was further supported by local radiotherapy combined with immunotherapy. During the treatment period, disease was relatively stable, but the patient suffered severe grade 4 myelosuppression. We were therefore left with no other choice than to interrupt both chemotheraphy and radiotherapy. Before long, the tumor grew explosively again. These guided us to conclude that the combination use of albumin-bound paclitaxel (nab-paclitaxel) and carboplatin and pembrolizumab is effective and well tolerated in the treatment of advanced cervical cancer. The combined use of radiotherapy and pembrolizumab may also be effective. However, the combination use of chemotherapy, radiotherapy and immunotherapy in advanced cancer has not been well studied, and there are still many unsolved queries.
机译:由于治疗方案有限,难以治疗先进的宫颈癌,使预后差。因此,需要探索新的治疗方式或组合。我们在本文中举报了一种阶段IVB宫颈癌的情况,其单独对化疗是不负责任的。基于以前的研究和患者的同意后,我们进行了治疗计划:化疗(白蛋白 - 结合的紫杉醇和卡铂)与免疫疗法联合(PD-1抑制剂Pembrozumab)。经过6个循环的组合治疗后,患者几乎完全解决了轻微的出现活动。通过局部放射疗法进一步支持治疗与免疫疗法相结合。在治疗期间,疾病相对稳定,但患者患有严重的4级骨髓抑制。因此,我们没有别的选择,而不是中断化学和放射治疗。在长期之前,肿瘤再次生长。这些指导我们得出结论,白蛋白结合紫杉醇(Nab-PACLitaxel)和Carboplatin和Pemblolzumab的组合使用在治疗晚期宫颈癌中是有效且良好的耐受性。放射疗法和Pembrolizumab的合并使用也可能是有效的。然而,在晚期癌症中的化疗,放射治疗和免疫疗法的组合使用尚未得到很好的研究,并且仍有许多未解决的查询。

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